Serum concentrations of vascular endothelial growth factor in an infant treated with ranibizumab for retinopathy of prematurity

Hoerster, Robert; Muether, Philipp S.; Dahlke, Claudia; Mehler, Katrin; Oberthür, André; Kirchhof, Bernd; Fauser, Sascha

doi:10.1111/j.1755-3768.2012.02469.x

Cited by 87 publications

(68 citation statements)

References 3 publications

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“…In contrast, Hoerster et al reported a case illustrating that serum VEGF reached a nadir at 2-3 weeks after intravitreal injection of ranibizumab, and normalized 4 weeks after injection [12]. Our study found that the plasma VEGF suppression started as early as 1 day after intravitreal injection of ranibizumab, and normalized 1 week after injection.…”

Section: Discussioncontrasting

confidence: 79%

“…Thus, there are concerns about the prolonged suppression of systemic VEGF, particularly in infants with very low body weight and rapidly developing tissues. Ranibizumab (Lucentis; Genentech Inc., South San Francisco, CA, USA), a humanized monoclonal antibody fragment Fab specifically designed for ocular use, acts as an ideal optional anti-VEGF agent for neovascular disorders, including ROP [8,12,13]. Considering the systemic suppression of VEGF, could ranibizumab be a safe choice in the management of ROP?…”

Section: Introductionmentioning

confidence: 99%

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Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab

Zhou

Jiang

Bai

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab

Zhou

Jiang

Bai

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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“…Follow-up of infants treated with intravitreal bevacizumab through 60 weeks' PMA found complications including persistent peripheral avascular retina, new intravitreal neovascularization, retinal detachment and macular dragging [50,51]. Reduced serum VEGF has been reported 2 weeks after intravitreal injection of bevacizumab or ranibizumab [52,53]. Although there is some promise with anti-VEGF treatment, there is risk of poor outcome and potential safety concerns from systemic reduction of VEGF, so further studies are needed.…”

Section: Anti-vegf Antibodymentioning

confidence: 99%

Retinopathy of Prematurity: Therapeutic Strategies Based on Pathophysiology

Cayabyab¹,

Ramanathan²

2016

Neonatology

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Retinopathy of prematurity (ROP) continues to be a major preventable cause of blindness and visual handicaps globally. With improved perinatal care, improved survival of moderately preterm infants, and limited resources for oxygen delivery and monitoring, more mature preterm infants are developing severe ROP in developing countries. The pathophysiology of ROP is characterized by two phases. Phase I ROP is due to vaso-obliteration beginning immediately after birth secondary to a marked decrease in vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1). Phase II begins around 33 weeks' postmenstrual age (PMA). During this phase, VEGF levels increase, especially if there is retinal hypoxia with increasing retinal metabolism and demand for oxygen leading to abnormal vasoproliferation. Since the original description of ROP in 1942 by Terry et al. [Am J Ophthalmol 1942;25:203-204], four epidemics of ROP have been observed. Prevention or early treatment of ROP involves careful titration of oxygen saturation by pulse oximeter (SpO₂). Optimal SpO₂ target remains elusive. Most of the large trials have focused on either a low SpO₂ (85-89%) or a high SpO₂ (91-95%) from the first day of birth to 36 weeks' PMA. Although the incidence of severe ROP and bronchopulmonary dysplasia decreased significantly, predischarge mortality was higher in these studies. Use of graded SpO₂ during the 2 different phases of ROP (early, low SpO₂ during phase I vs. late, high SpO₂ during phase II) may be the best approach to prevent this disabling condition. Further trials should focus on this strategy. Other biological agents that are currently being studied include IGF-1 with IGF-binding protein-3 (rhIGF-1 + rhIGFBP-3) and propranolol. For advanced stages of ROP, laser ablation of avascular retina, early treatment of ROP (ETROP) protocol, intravitreal injection of anti-VEGF antibodies (e.g. bevacizumab) and vitrectomy are used to protect central vision and prevent retinal detachment. Long-term complications such as refractory errors, recurrence of ROP and risk of retinal detachment require continued follow-up with an ophthalmologist through adolescence and beyond. Optimal nutrition including adequate intake of omega-3 polyunsaturated fatty acids and decreasing infection/inflammation to promote normal vascularization are important strategies. Screening guidelines for ROP based on local incidence of ROP in different regions of the world are very important. Oxygen therapy is clearly a modifiable risk factor to decrease ROP that needs further study. Understanding the two phases of ROP will help to identify appropriate therapeutic strategies and improve visual outcomes in many preterm infants globally.

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“…Menke et al [20] reported that vascularization was completed without recurrence after 0.03 ml IVR. Another study [22] showed that after 0.2 mg ranibizumab applied intravitreally, all cases demonstrated recurrence. The present study showed that recurrence could happen in both groups, although the ranibizumab group displayed significantly more recurrence than the bevacizumab group.…”

Section: Discussionmentioning

confidence: 99%

The Process of Retinal Vascularization after Anti-VEGF Treatment in Retinopathy of Prematurity: A Comparison Study between Ranibizumab and Bevacizumab

Sukgen

Çömez²,

Koçluk³

et al. 2016

Ophthalmologica

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Purpose: To compare the effects on the process of retinal vascularization of intravitreal ranibizumab (IVR) and intravitreal bevacizumab (IVB) in the treatment of severe retinopathy of prematurity. Methods: The present study is a bi-centered retrospective study. While 44 eyes of 22 patients in group 1 were applied 0.625 mg bevacizumab, 46 eyes of 23 patients in group 2 were applied 0.25 mg ranibizumab. Retinal vascularization was evaluated clinically. Results: The mean time for completion of vascularization was found to be postmenstrual 55.93 ± 4.13 weeks in group 1 and 56.30 ± 4.30 weeks in group 2. There were signiﬁcant differences in the recurrence prevalence between the two groups. The prevalence of recurrence was found to be significantly higher in the ranibizumab group than in the bevacizumab group (p = 0.023). Conclusions: The study showed that after IVR or IVB treatment, vascularization could be completed with delay; there were no differences in this delay time between the ranibizumab and bevacizumab groups. Besides, avascular areas may remain in the peripheral retina, and additional treatment may be necessary after IVB or IVR treatment. When the treatment was applied as monotherapy, more recurrence was observed in the ranibizumab group.

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Serum concentrations of vascular endothelial growth factor in an infant treated with ranibizumab for retinopathy of prematurity

Cited by 87 publications

References 3 publications

Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab

Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab

Retinopathy of Prematurity: Therapeutic Strategies Based on Pathophysiology

The Process of Retinal Vascularization after Anti-VEGF Treatment in Retinopathy of Prematurity: A Comparison Study between Ranibizumab and Bevacizumab

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